PCSK9 Inhibitors Show Promise in Acute Coronary Syndrome

(HealthDay News) — Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies may represent a promising treatment option for acute coronary syndrome (ACS), according to a review published online March 22 in the Annals of Internal Medicine.

Noting that monoclonal antibodies that inhibit PCSK9 are an emerging therapy for dyslipidemia, Eliano P. Navarese, MD, PhD, from Heinrich Heine University in Düsseldorf, Germany, and colleagues reviewed the literature to discuss the use of PCSK9 antibodies in patients with ACS.

The researchers note that levels of PCSK9 increase in ACS. PCSK9 antibodies can have a dual effect in improving clinical outcomes, with a reduction in lipid fraction and inhibition of PCSK9. Acute inhibition may benefit patients via several mechanisms, including the reduction of low-density lipoprotein (LDL) cholesterol levels. In addition, PCSK9 inhibition was associated with anti-inflammatory and antiplatelet effects that could result in direct plaque stabilization, conferring early benefit.

“Despite the robust clinical rationale and preclinical data that support the potential benefit of PCSK9 antibodies beyond reduction of LDL cholesterol levels in ACS, further studies are required to confirm this hypothesis,” the authors write. “To definitively demonstrate that PCSK9 antibodies have dual antidyslipidemic and plaque-stabilizing effects in the early phase of ACS that may translate into improved clinical outcomes, a large-scale, randomized, controlled trial powered for clinical end points is needed.”

Several authors disclosed financial ties to the pharmaceutical industry.